The new professor knows how to turn cells into therapy

Long traditions of good deeds

Donated blood products have been used to treat patients since the beginning of the 20th Century, and the world’s first stem cell transplantations were conducted in the 1960s.

Finland began stem cell transplantations in 1974, and as few patients had suitable donors in their families, a registry of voluntary stem cell donors was established in Finland in 1992.

Paediatric stem cell transplantations have been centralised at the Children’s Hospital of the Hospital District of Helsinki and Uusimaa, and this year it completed its 500th transplantation. Adult patients can receive transplantations in the Meilahti Hospital and in Turku, and the total of all adult transplantations is already well over 1,000.

At the moment, more than 30,000 Finns have registered for the stem cell donor registry, but most of the transplantations still use donated cells from central Europe. The crucial factor in selecting a suitable donor is their HLA type. HLA, or the human leukocyte antigen, is the foundation of the body’s immune defence. If the transplanted material has the wrong HLA type, the body will reject it.

If the patient has an HLA type that is typical of the Finnish genome, it will often be easy to find donors in the Finnish registry, but if the type is rarer, it can be challenging to find a donor, even if the search extends abroad.

The Good Deeds (Hyviä tekoja) campaign, organised by the University of Helsinki and the Blood Service of the Finnish Red Cross, highlights research cooperation in blood transfusions and cell transplantations while encouraging members of the University community to donate blood. Every work day, Finland needs 800 blood donors.

The newly appointed professor of cell therapy and transfusion medicine, Kim Vettenranta, treats children whose only hope is a stem cell transplantation.

The staff and patients of the K10 Pediatric Cancer Ward are waiting for the new Children’s Hospital’s construction to finish in temporary facilities in the Meilahti Triangle Hospital. It is the workplace of Kim Vettenranta, Chief of clinic at the Pediatric Oncology, Hematology and Stem Cell Transplantations Outpatient Clinic, and newly appointed professor at the University of Helsinki’s Faculty of Medicine.

The professorship for cell therapy and transfusion medicine is funded by a donation from the Finnish Red Cross Blood Service, and the connection to the Blood Service is clearly apparent in Vettenranta’s new duties.

“I see my role as a stool with three legs – no leg can be sawn off without the whole thing toppling over,” says Vettenranta, referring to the close cooperation between the University, the Hospital and the Blood Service in enabling and developing cell therapies.

In his work at the hospital, Vettenranta meets the youngest of cell therapy patients: children with cancer and severe immunological diseases who are being treated with transplantations of stem cells that can generate blood.

Professor Kim Vettenranta. Photo: Elisa Lautala.

The typical associations with stem cell transplantations are different types of leukaemia, ie. blood cancer, which are consistently the most common reason for stem cell transplantations in adults.

For children, the situation has changed dramatically during the past few years, as the chemotherapy for the most common leukaemia in children, acute lymphatic leukaemia (ALL), has become so effective that more and more patients recover thanks to them.

In Finland, only a third of all paediatric stem cell transplantations are done on leukaemia patients. However, the portion of various immunological diseases in pediatric stem cell transplantations has increased significantly.

Without stem cell treatment, many of these young patients die relatively quickly.

“These diseases are being diagnosed more efficiently and more precisely, so they can be found in their early stages. Without stem cell treatment, many of these young patients die relatively quickly,” says Vettenranta.

New forms of cell therapy

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According to Vettenranta, transplanting stem cells that can generate blood will not be the only form of cell therapy.

New treatments are being studied extensively, particularly in the field of regenerative medicine. This means that cells could be used to repair damages to the nervous system or tissues, spinal column injuries or even damages to the heart muscles after a heart attack. At the moment, these are far from routine treatments.

Another new form of cell therapy is the use of genetically modified T cells, or CAR-T cells, in the treatment of cancer. This therapy is sure to become routine before the next decade.

“In CAR-T cell therapy, the patient’s own immune system, which cannot detect the leukaemia, is forced to see the cancer cells as targets to be destroyed. Internationally, the treatment is already in use at a few institutions, and two Finnish children have received the treatment as part of an international trial,” says Vettenranta.

CAR-T cell therapy will become routine treatment during this decade.

CAR-T cell therapy is likely to be adopted as a form of treatment for the most difficult cases of leukaemia in Finland, possibly as early as in 2019. In addition, its use in treating other forms of cancer is currently being studied internationally. The goal is that in the future, CAR-T cells could be cultured from donated cells and stored in biobanks where they would be easily available when needed.

The new professorship in cell therapy and transfusion medicine will boost research and development in new forms of cell therapy on the Meilahti Campus. For example, the Campus has thus far had no research laboratory dedicated exclusively to cell therapy.

“This is an interesting new vantage point, and I welcome the challenges. My job is to facilitate research cooperation and promote international networking,” states Vettenranta.